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Lifetime cost of HIV care in France during the era of highly active antiretroviral therapy.

Abstract：

OBJECTIVE:To estimate the treatment and health care costs of HIV infection or AIDS in France during the era of highly active antiretroviral therapy (HAART). DESIGN:We used a clinical database of HIV-infected patients to calculate the resource use and cost of care for different stages of HIV infection. Costs were incorporated into a computer-based, probabilistic simulation model of the natural history and treatment of HIV infection to estimate the lifetime cost of treating patients with HIV disease. SETTING:A northern France HIV clinical cohort. PARTICIPANTS:1232 HIV-infected patients followed from January 1994 through July 1998. RESULTS:In the absence of an AIDS-defining event, the average total cost of care ranged from 670 euros (1 euro=US $1.19) per person-month in the highest CD4 stratum (>500/microl) to 1060 euros per person-month in the lowest CD4 stratum (< or = 50/microl). The mean cost of care was estimated at 3370 euros per person-month during the initial months around the occurrence of an AIDS-defining event; at 1750 euros per person-month during the period spanning from 2 months after the diagnosis of specific AIDS-defining event to 1 month prior to death; and at 13010 euros per person-month in the final month prior to death. If clinical management of HIV infection began at a CD4 cell count of 378/microl, as in this cohort, the discounted lifetime cost of treating an HIV-infected French patient was estimated at 214000 euros. The undiscounted costs were 309000 euros over a projected life expectancy of 16.4 years. CONCLUSION:The cost of HIV disease varies widely depending upon the stage of illness. These estimates of stage-specific and lifetime costs of HIV care will assist health policy planners in assessing the burden of disease in the era of HAART and projecting future resource requirements.

journal_name

Antivir Ther

journal_title

Antiviral therapy

authors

Yazdanpanah Y,Goldie SJ,Losina E,Weinstein MC,Lebrun T,Paltiel AD,Seage GR 3rd,Leblanc G,Ajana F,Kimmel AD,Zhang H,Salamon R,Mouton Y,Freedberg KA

subject

Has Abstract

pub_date

2002-12-01 00:00:00

pages

257-66

issue

eissn

1359-6535

issn

2040-2058

journal_volume

pub_type

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Lifetime cost of HIV care in France during the era of highly active antiretroviral therapy.